Ola Bratt, MD, PhD, in a commentary on the STHLM3-MRI study of MRI for prostate screening.

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MR Scanners

MRI’s Value for Prostate Screening

Among cancer screening tests, prostate screening could be the most problematic. But a new study published this week in JAMA Network Open offers guidance on the role that MRI can play in making prostate screening more effective – and opening the door to population-based screening.

The problem with prostate screening is that PSA tests often discover disease that’s either indolent or slow-growing. 

• This can lead to a cascade of interventions that are expensive and have harms of their own. 

But prostate cancer remains a common – and deadly – cancer, with 1.5M cases globally in 2022, and it’s the second most commonly occurring cancer in men after lung cancer.

• Given these statistics, there has to be a way to perform prostate screening more effectively.

MRI offers one such alternative, and a clinical consensus has emerged that performing a single MRI scan after a positive PSA result can help stratify men before biopsy. 

• In this scenario, men might not be referred to biopsy if their MRI scan is negative, and adoption of this protocol has helped reduce prostate biopsies in PSA-positive men while still detecting clinically significant cancer.   

But if one MRI scan is good, are repeat MRI scans even better? In the new study, Swedish researchers investigated this question in a secondary analysis of the STHLM3-MRI trial, which involved repeat screening of 1.5k men 2-3 years after an original prostate screening.

Of the group who got repeat PSA and MRI screening, 667 men had PSA levels of 3 ng/mL or higher, the threshold for MRI testing, with the repeat scans finding … 

• 51 men (7.6%) had equivocal lesions (PI-RADS score of 3)
• 33 men (4.9%) had suspicious lesions (PI-RADS score of 4)
• Only 10 men (1.5%) had lesions with PI-RADS scores of 4 or greater

The findings led the authors to conclude that cancer detection was “limited” in the second round of PSA and MRI prostate screening, and detection of low-grade tumors was low.

The Takeaway

At first blush, STHLM3-MRI may seem like a negative study, but it actually helps frame the debate over prostate cancer screening and MRI’s role by omitting the need for multiple repeat scans. The results also give clinicians confidence that it’s safe to omit prostate biopsies in men who have a single negative MRI result – a key finding in reducing the downstream costs of any population-based screening program.

What You Need to Know about the 2024 MPFS Final Rule

CMS updates the Medicare Physician Fee Schedule (MPFS) annually, and 2024 is no different. Join Barbara Rubel of MSN Healthcare Solutions as she reviews the key provisions that will impact radiology in this February 13 webinar hosted by Medality. 

Home-Based Cardiac Ultrasound

How is home-based AI-aided cardiac ultrasound poised to change global healthcare? In this article from Us2.ai, hear from Izabella Uchmanowicz, RN, on how the CUMIN study is empowering nurses to perform AI-POCUS.

The Wire

• KLAS Issues 2024 Awards: Market analysis firm KLAS has issued its 2024 Best in KLAS awards, ranking top vendors across healthcare IT market segments including radiology. Congratulations to the awardees, including Intelerad (PACS for UK and Ireland), Merge by Merative (cardiology and cardiology hemodynamics), and Nuance (image exchange), as well as other leaders like Sectra (Iarge and small PACS), Agfa HealthCare (universal viewer), 3M M*Modal (front-end speech recognition), and Fujifilm (VNA). 

• Improving ABUS with BRAID: UK researchers are investigating automated breast ultrasound as an adjunct to screening mammography for women with dense breasts in the BRAID trial. In Clinical Radiology, they describe their experiences with GE HealthCare’s Invenia ABUS 2.0 system and how after one year of use they saw improvements in average exam time (20 minutes vs. 60), reporting times (3.7 minutes vs. 6), and image quality (75% rated as very good/optimal). Further research is recommended on the use of ABUS with AI and post-processing.

• Screening Skeptic Questions USPSTF Change: Most breast imaging specialists and women’s health advocates cheered last year when the USPSTF restored its guidance that breast screening start at 40. But not everyone has been happy with the move. In an editorial in Annals of Internal Medicine, Russell Harris, MD, laments the change, claiming that moving the screening age 10 years earlier creates confusion and exposes more women to the “harms” of screening. Harris was a member of the USPSTF in 2009 when it raised the age from 40 to 50.

• ACR Response Supports Screening: The Harris editorial drew a spicy response from the ACR, which started by saying Harris “relies on obsolete, hyperbolic information.” ACR notes that the breast cancer death rate has dropped 40% since screening became widespread in the 1980s, and Harris’ reliance on “outdated randomized controlled trials (RCT) to inform screening policy can cost lives,” especially since the first mammography RCT was conducted over 60 years ago. Finally, the ACR accuses Harris of overstating the risks of breast screening, such as anxiety and overdiagnosis. 

• Qure AI TB Tapped As Breakthrough: An AI algorithm under development by Qure.ai for detection of tuberculosis on chest X-rays has received breakthrough device designation from the FDA. Qure’s qSpot-TB algorithm is a second-read computer-aided detection and diagnosis algorithm that analyzes chest X-rays for signs of TB. Qure notes that TB continues to be a health problem in developing countries, while rates in western countries like the US and UK have ticked up following the COVID-19 pandemic. Qure is working with the FDA on final requirements for a 510(k) submission.

• Ezra Raises $21M: Whole-body screening provider Ezra has raised $21M, a sign that investors still have a healthy appetite for wellness imaging firms. The round was led by Healthier Capital and FirstMark Capital, and Ezra will use the funds to fuel a US expansion that should grow the company from 18 locations to 50 sites in 20 cities across the US by 2024’s end. Ezra also intends to achieve profitability in the next 12-18 months. Most recently, the company got clearance for its Ezra Flash AI brain MRI software. 

• Low-Field Breast MRI: Breast MRI has established itself as an adjunct to X-ray mammography, but the high cost of MRI can limit its use in resource-challenged areas. Could low-field MRI be a solution? Writing in European Journal of Radiology, German researchers described their experience with Siemens Healthineers’ Magnetom Free.Max, a 0.55T scanner, with a seven-channel breast coil. They scanned 12 women, reporting “acceptable” image quality with scan times of 11-19 minutes, suggesting that low-field MRI could be an alternative to high-field scanners for breast MRI.

• PE Firm Takes Control of Akumin: Beleaguered imaging center operator Akumin has been taken private by its main creditor, private equity firm Stonepeak, as part of the company’s Chapter 11 proceedings. The move was announced last year as Akumin struggled to meet the terms of a $470M loan from Stonepeak; the PE firm said it would invest an additional $130M into Akumin. 

• Texas Health Systems Choose PocketHealth: Three health systems in Texas will be installing software from PocketHealth to improve patient access to medical images and reports. South Texas Health System, Fort Duncan Regional Medical Center, and Midland Health will be installing PocketHealth’s solutions to help patients access and understand their reports and eliminate inefficiencies like burning CDs. The deals include PocketHealth’s Report Reader application as well as MyCare Navigator, launched late last year. 

• Philips Recalls SPECT System: Philips has issued a recall notice for its BrightView SPECT system following a report that a component failure could cause a detector head to move downward and contact the patient; there have been no reports of patient injury. The FDA has classified the event as a class I device recall, and Philips is in the process of making corrections in the field. Philips stopped selling BrightView in 2014, and there are nearly 600 systems in the field, 302 of which are in the US. 

• DOJ Charges Cardiac PET Provider: The US Department of Justice has filed a complaint under the False Claims Act charging the former owner of a cardiac PET firm with violating the Stark anti-self-referral law. DOJ claims that Rick Nassenstein, former head of Cardiac Imaging of Illinois, allegedly paid referring cardiologists as if they were fully occupied supervising PET scans when actually they were providing care to other patients or were not on site. Cardiac Imaging last year paid $85M to settle related kickback charges.

• Rise in Medical Malpractice Verdicts: Verdicts in medical malpractice cases are on the rise, with recent verdicts in the hundreds of millions of dollars. A chilling new article in Medscape details the trend, citing statistics from reinsurance company TransRe showing 2023 set records for high medical practice verdicts, including $120M awarded in a New York case in which a stroke was missed on a brain CT scan. A rollback of tort reform is cited as one reason, as well as anger at the healthcare system following the COVID-19 pandemic.

Meet Gleamer at ECR 2024

Learn all about Gleamer and its portfolio of AI solutions, including its BoneView algorithm for detecting fractures in adults and children, at the upcoming ECR 2024 conference. Schedule a meeting today.

Next-Generation Radiology Reporting

Listen to the conversation in this webinar recording and hear from PACS administrator Griff R. Van Dusen of Memorial Health System how Nuance PowerScribe One’s next-generation reporting experience helps streamline workflow and improve report quality so radiologists can get more done in less time.

Go Virtual with Ease

Visage Imaging’s new Visage Ease VP solution makes it easy for you to take advantage of the unique clinical capabilities of the new Apple Vision Pro spatial computing environment. Learn how it can change your practice today.

The Resource Wire

• How AI Empowers Radiologists: Learn how the use of AI-based tools for cancer screening holds immense promise for addressing the lack of trained radiologists in this downloadable eBook from Bayer. 

• Improving Access and Efficiency at William Osler Health: Watch how PocketHealth helped William Osler Health System eliminate CD-burning and redirect staff through patient-driven image exchange. Watch this video interview with Aimee Langan, Director, Diagnostic Imaging, Laboratory, Neurodiagnostics.

• The Value and Impact of Amyloid PET Imaging: The value and impact of amyloid PET imaging is burgeoning in the context of new therapies entering the market. Join GE HealthCare and RadNet’s Suzie Bash, MD, in a discussion of the exciting possibilities in this February 8 webinar. 

• Looking to Get Started with AI? Learn how Milton Keynes University Hospital adopted a successful AI strategy in this on-demand webinar from Blackford. You’ll discover how to evaluate and select the best AI solutions for your facility, tips for getting started with AI, and more. 

• Discover How to Unlock Dual-Source CT: Discover how dual-source CT technology from Siemens Healthineers delivers the temporal resolution and scan speed needed to reduce motion articles, and how the company is making dual-source CT available to a wider range of hospitals and imaging centers.

• Best in KLAS for Cardiovascular Imaging: The Merge Cardio and Merge Hemo solutions from Merge by Merative have been named Best in KLAS 2024 for Cardiology and Hemodynamics. Learn more about the solutions that have dominated both KLAS categories since 2007.

• Challenges of Messy Data in Healthcare Research: Data is the lifeblood of healthcare research, but one hurdle faced by researchers is messy data. Learn the top five strategies for effective data management in healthcare research in this article from Enlitic. 

• Your Single Solution for AI, 3D, and Full Interoperability: Realize immediate value across your organization with subscription-based advanced visualization and AI from TeraRecon that accelerates imaging workflows and improves patient outcomes. Schedule a demo today. 

• Solutions to Transform Medical Image Delivery: Medical providers and health systems are looking to ditch the disc and modernize their patients’ journey. Learn how Clearpath helps them reduce the cost of retrieving and fulfilling patient requests for imaging and medical records.

• Unleash the Power of the Cloud: Change Healthcare’s cloud-native, zero-footprint Stratus Imaging PACS is live in clinical use. See how Stratus Imaging PACS is helping radiology practices improve productivity and patient care, while eliminating the cost and resource constraints of on-premise systems.

• AMRIC’s Multimodality Approach to Medical Imaging: AMRIC is a new premium imaging clinic on Manhattan’s Upper East Side. Learn about their multimodality approach to medical imaging and why they turned to United Imaging for cutting-edge CT, MRI, and molecular imaging technology. 

• Revolutionizing Radiology with Clear Visual Intelligence: The University of New Mexico Hospital is partnering with Riverain Technologies to revolutionize radiology with the use of ClearRead CT with Clear Visual Intelligence for chest CT scans. Get details about the partnership on this page.

• Radiology Automation Simplified: A recent statement by top radiology societies states that there should be close collaboration between the developers and users of AI. Find out in this video how CARPL.ai worked with University Hospitals, Cleveland for AI testing, deployment, and monitoring. 

• Best in KLAS PACS: Intelerad’s InSight PACS has been named Best in KLAS for UK and Ireland PACS by KLAS Research. Learn more about the solution that’s been adopted by over 250 healthcare providers across the UK and Ireland. 

• Two Questions about AI for Radiology Leaders: Are today’s radiology AI solutions solving the right problems? And are there other solutions available for AI of brain MRI? Read this article from SpinTech MRI to learn how its STAGE solution can optimize MRI utilization.